Anyone ever been faced with trying to be patient advocate with a doctor who obviously doesnt care or is too ignorant to know? Thursday night, I almost decided to quit nursing altogether. I had a patient with massive ascites (no obvious ascites the night before) who was on a regular diet and also had a dobhoff receiving tube feedings at 70 ml/hr. He was receiving IV fluids at 125 ml/hr. He should have been on low Na diet with fluid restriction. He was in severe resp. distress with massive lung crackles. I called the hospitalist on call and I had to tell him what orders I wanted! (chest xray, KUB to verify dobhoff placement, etc) He had no clue! I had to call this doc approx. 12 times through the night over this situation. I finally had to INSIST he come to the floor to take a look at this patient. While on the floor, the pt codes. What does the doc do? He just stands there! He leans against the wall and watches me call code, frantically running to get suction and supplies/crash cart. Then what does he do....HE LEAVES! I reported him. Unfortunately, nothing will come of it. This happens all the time here at this hospital. The same night, another pt's blood glucose was bordering 600 all night, he was on solumedrol for resp. probs with hx of DM. Insulin was making no difference because his fingersticks were only QID. I did a fingerstick about q 2 hr and called this doc every time. His response, "give him 10 units of whatever kind of insulin you want to". OMG! During this whole time, my charge nurse just sits back and watches, would NOT help me! I didnt get to leave until 3 1/2 hours post shift. I called in sick the next night because I just couldnt go back so soon after all this. Im just sick about it. MRSA and VRE are rampant and pt's die left and right. Anyone else work in a hospital like this?
